fMRI “deactivation” of the posterior cingulate during generalized spike and wave

• Published in: NeuroImage (Orlando, Fla.) Fla.), 2003-12, Vol.20 (4), p.1915-1922
• Main Authors: Archer, John S, Abbott, David F, Waites, Anthony B, Jackson, Graeme D
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Age; Brain Chemistry - physiology; Electroencephalography; Epilepsy; Epilepsy, Absence - physiopathology; Epilepsy, Generalized - metabolism; Epilepsy, Generalized - physiopathology; Female; Gyrus Cinguli - metabolism; Gyrus Cinguli - physiopathology; Humans; Image Interpretation, Computer-Assisted; Magnetic Resonance Imaging; Male; NMR; Nuclear magnetic resonance; Oxygen - blood; Patients; Studies
• ISSN: 1053-8119; 1095-9572
• DOI: 10.1016/S1053-8119(03)00294-5

Using spike-triggered fMRI, we sought to document regional changes in blood oxygen level-dependent (BOLD) activity associated with spontaneous generalised spike and slow-wave discharges (S&W). Five adult patients were studied who had idiopathic generalised epilepsy (IGE) and frequent S&W. EEG was recorded inside a 3T MRI, allowing acquisition of single, whole-brain fMRI images following S&W, as well as baseline images. Between 4 and 25 spike and wave complexes were captured in individuals. Four of the five individuals showed significant S&W-related BOLD signal reductions (“deactivation”) in the posterior cingulate ( P < 0.001 uncorrected). Significant changes were absent only in the individual with fewest spikes. Group analysis including all five subjects confirmed fMRI deactivation in the posterior cingulate. Some S&W-related BOLD signal increases were seen in the depths of the precentral sulci in individuals and on group analysis. No significant S&W-related changes in thalamic BOLD activity were observed. The posterior cingulate may have a role in the electroclinical phenomenon of S&W and “absence.” Possibilities include a causative role, with reduced activity in the cingulate facilitating the onset of S&W, a secondary role, explaining the cognitive changes observed during prolonged S&W, or an epiphenomenon.